The Pastel Agenda

Every person has something or someone to fight for, especially if it’s personally significant to them. But, what’s more beautiful is fighting for a struggle one doesn’t personally experience. It doesn’t just become personally meaningful, it becomes meaningful for everyone. In this opinion piece, we illustrate why it’s important to fight for a cause that everyone should have the right to. The chance to become their true self.

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In the face of ongoing legislative efforts to ban gender-affirming care, individuals become vital agents in forwarding a more inclusive public healthcare system. Each person possesses the power to educate themselves and others about the significance of gender-affirming care for transgender individuals. By staying informed, engaging in discussions, and challenging misconceptions, individuals can foster understanding and empathy within their communities. Moreover, examining the topic of transitioning through socio-political and psychological lenses allows us to comprehend the broader significance and impact of advocating for gender-affirming care.

Socio-political

Advocating for transitioning is vital from a socio-political perspective because it addresses the rights and equality of transgender individuals. Transition-related medical care, also known as gender-affirming therapy, aims to support individuals in aligning their primary and secondary s*xual characteristics with their gender identity. Its purpose is to facilitate the adjustment process and ensure that an individual's physical attributes are in line with their identified gender. The restriction or denial of medical care for transgender individuals, whether through explicit coverage refusal or implicit bias and lack of knowledge among healthcare providers, can have negative consequences on their health and well-being in the short and long term (Stroumsa, 2014). Hence, it is crucial to challenge discriminatory practices and policies, educate healthcare providers about the specific healthcare needs of transgender individuals, and ensure that gender-affirming care is recognized as an essential aspect of comprehensive healthcare.

Psychological

Advocating for transitioning is deeply connected to the psychological well-being of transgender individuals. Transitioning, with the support of medical and mental health professionals, has been shown to improve mental health outcomes. According to a study in the Stanford University School of Medicine, transgender individuals who initiated hormone treatment during adolescence experienced lower rates of suicidal ideation, a reduced likelihood of major mental health disorders, and fewer issues with substance abuse compared to those who started hormone treatment in adulthood. The study also found that individuals who received hormone treatment, regardless of age, had better overall mental health compared to those who desired but did not receive the treatment (Digitale, 2022). These findings highlight the importance of advocating for accessible and supportive transitioning resources, which play a vital role in promoting the psychological well-being of transgender individuals.

In conclusion, advocating for transitioning is of utmost importance in both socio-political and psychological contexts. From a socio-political perspective, it addresses the rights and equality of transgender individuals, challenging discriminatory practices and promoting comprehensive healthcare that includes gender-affirming care. While on the psychological front, advocating for transitioning recognizes its positive impact on mental health outcomes. Truly, it is through our collective efforts, informed understanding, and commitment to equality that we can create a society where transitioning is recognized, respected, and supported, promoting the overall welfare and empowerment of transgender individuals

Myth: a widely held false belief or idea (Oxford Dictionary, n.d.)

Medical transitioning is the most popular type of transitioning known to everyone. However, misconceptions come with such a reputation. Through this infographic, allow us to help you better understand the true experiences of our trans brothers and sisters.

Be informed and pay it forward!

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MYTH: Hormone therapy and surgery are top priorities for all transgender individuals
FACT: Not all transgender individuals undergo hormone therapy or surgery as part of their transition

The decision to pursue medical interventions is highly personal and varies from person to person. Some individuals may find that hormone therapy aligns with their needs and helps them feel more comfortable in their bodies, while others may prefer to focus on social transition, which involves changes in presentation, clothing, and pronoun usage without the use of medical interventions.

MYTH: Puberty blockers are not reversible
FACT: Puberty blocks are both temporary and fully reversible

When an individual discontinues the usage of puberty blockers, their body will revert to regular puberty, and any long-term consequences are expected to be minimal, if existent. Although there may be a decrease in bone mineral density, this can be easily remedied by taking calcium and vitamin D supplements.

MYTH: Most young people that transition regret their decision and want to “de-transition.”
FACT: Detransitioning is quite rare—with some studies finding levels of detransition and regret as low as 1% or 2%.

Transgender adolescents who fulfill the criteria for gender dysphoria and opt for social or medical transition are statistically unlikely to undergo detransitioning. A recent study published in the academic journal Pediatrics tracked over 300 transgender youth who initially underwent social transition, revealing that more than 92% remained unwavering in their gender identity even after five years.

According to a study published in The Lancet in 2022, 98% of transgender teenagers who received gender-affirming hormones continued to identify as transgender and utilize these hormones. Those who discontinued hormone use often did so due to reasons such as financial constraints, medical factors, or other considerations, rather than a change of heart regarding their gender identity. Another study conducted in 2021 found that 82% of individuals who detransitioned did so primarily due to external factors like discrimination or rejection from their families, indicating that it was safer for them to conceal their true gender identity. Although there are a few cases of individuals realizing they are not transgender and experiencing regret after transitioning, these instances are exceptionally rare, estimated at only 0.4% of the transgender population.

References
Debunking the myths about gender-affirming care. Accessed June 21, 2023. https://www.socialworkers.org/LinkClick.aspx?fileticket=SfQYdWPJAoY%3d&portalid=0.

Rodriguez, Orion. Common Myths about Transgender Health Care. Lifeworks Northwest. https://www.lifeworksnw.org/2023/03/20/common-myths-about-transgender-health-care/.

As illustrated prior, there are factors present that continue to marginalize Filipino trans men and women. Consequently, limitations and challenges come into play into their experiences as a trans person living in this country. In this opinion piece, let us talk about how these factors contribute to the continued discrimination of the Filipino LGBTQ+ community and the steps the country can take to become truly inclusive.

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While the Philippines has been regarded as one of the most LGBTQI+-friendly countries in Asia, it is important to recognize that transgender people continue to experience marginalization and neglect when it comes to the protection and fulfillment of their human rights. They still face barriers in their various aspects of life, such as legal recognition, education, employment, healthcare, and so many more. Transgender individuals also often become victims of violence and discrimination.

One of the primary challenges that transgender individuals’ encounter is the limited availability of gender-affirming healthcare services. These services are crucial for transgender individuals as they contribute to their mental health condition, self-confidence, and overall quality of life and well-being. Despite these benefits, access to these services in the country has been limited and hindered by systematic barriers.

The first barrier faced by transgender individuals in the Philippines is the limited availability of healthcare providers who specialize in transgender healthcare and possess sufficient knowledge about their specific needs. This scarcity creates a significant barrier to accessing adequate support for medical transitioning. Additionally, the lack of standardized care and the absence of transgender health information in medical school curricula further contribute to the knowledge gap among healthcare professionals, exacerbating the challenges faced by transgender individuals.

The second challenge about access to medical transitioning is the financial aspect of undergoing treatment. The expenses associated with gender-affirming procedures, such as hormone therapy, gender-affirming surgeries, and related treatments, can be very expensive. The high costs make these procedures financially unattainable for many transgender individuals, particularly those with limited financial resources. Additionally, the lack of insurance coverage or benefits for gender-affirming procedures and transgender healthcare needs from government healthcare programs, such as PhilHealth, adds to the financial burden.

Other issues that hinder transgender to access their needed medical intervention is the existence of societal stigma and discrimination in the healthcare setting. One of the distressing consequences of this discrimination is the suboptimal care that transgender individuals may receive from healthcare providers. Some healthcare professionals may lack the necessary knowledge, training, or empathy to provide appropriate and affirming care to transgender patients. This can result in inadequate support, misdiagnosis, or the denial of essential treatments and procedures related to gender-affirming healthcare.

The limited support and challenges in the access for medical transitioning leaves many transgender individuals with few options. Some resort to self-medication, obtaining medications or performing medical procedures without proper medical supervision or guidance. This practice poses significant risks, as self-administered medical treatment can lead to serious consequences that can harm the health and well-being of the individual.

To address these limitations and challenges, several recommendations can be made. First and foremost, there is a pressing need for the Philippine government to enact a anti-discrimination law such as the SOGIE bill, that protects LGBT people from further discrimination.

Second, the Department of Health should recognize the healthcare needs of transgender as a public health concern and should establish comprehensive guidelines and standards of care for transgender health. These guidelines should encompass the full spectrum of medical transitioning, including hormone therapy, gender-affirming surgeries, and post-operative care. DOH should also ensure that there is adequate training and education for healthcare professionals on transgender healthcare should be integrated into medical school curricula and continuing education programs.

Third, the government should explore options for providing financial support, such as insurance coverage or subsidies for gender-affirming procedures. PhilHealth and other healthcare programs, such as the Universal Healthcare Law, should include comprehensive coverage for transgender healthcare needs, ensuring that these services are accessible and affordable for all individuals.

In conclusion, while the Philippines has made strides in becoming an LGBTQIA-friendly country, it is imperative to recognize the limitations and challenges those transgender individuals face, particularly in accessing support for medical transitioning. Addressing these issues requires fighting against SOGIE based discrimination. By taking these steps, the Philippines can move closer to truly embracing and supporting all members of the transgender community.

Though medical transitioning is accessible in a lot of countries, the same cannot be said for the Philippines. As a result of several factors at play, Filipino trans men and women encounter difficulties in accessing services such as hormone therapy and gender-affirming surgery. Together, let us have a look at the current state of medical transitioning in the country.

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Current State of Medical Transitioning in the Philippines

Currently, the Philippines lacks specific laws or policies that regulate medical transitioning for transgender individuals. The Department of Health (DOH) has not yet established a standard of care or guidelines to address the specific needs of transgender individuals despite the constant demand from various groups.

This created significant challenges for transgender individuals seeking healthcare.

1) Self-medication

Transgender individuals often acquire hormone replacement therapy (HRT) medications without proper medical supervision or guidance regarding correct usage, dosage, and potential side effects.

This practice poses significant risks, as self-administered hormones can lead to overdosing and various adverse effects or complications.

There have been documented cases in which transgender women who took incorrect hormone dosages experienced adverse reactions such as palpitations, elevated blood pressure, and heart attacks.

2) Discrimination and knowledge gap in the healthcare system

Transgender individuals often face discrimination and prejudice when they seek healthcare services.

There are also some instances where healthcare personnel, including receptionists, nurses, physicians, and other staff members, have enabled and perpetuated stigma and discrimination.

There is a scarcity of healthcare providers in the Philippines who specialize in transgender healthcare and possess adequate knowledge about the specific needs of transgender individuals.

The absence of a standardized approach to care makes it difficult to monitor and ensure the quality of healthcare provided to transgender people.

3) Medical transition is expensive

Medical transitioning procedures, such as hormone therapy, gender-affirming surgeries, and related treatments, can be very expensive.

S*x reassignment surgery can cost from a few hundred thousand pesos to more than P1 million while hormone pills and injectables costs P3 to 4 thousand and above (Philippine Daily Inquirer, 2016; De Guzman, 2018; Singson, 2016)

There's also a lack of insurance coverage or benefits for gender-affirming procedures and transgender healthcare needs from government healthcare programs.

Without insurance coverage, the financial burden falls entirely on the individual, often leading to postponed or forgone treatments

References

Abesamis, L. E. A. (2022). Intersectionality and the invisibility of transgender health in the Philippines. Global Health Research and Policy, 7(1). https://doi.org/10.1186/s41256-022-00269-9

Alegre, B. R. (2022). Ganda ng Transpinays: Narratives on Trans Health, Barriers to Care and Trans Sisterhood in the Philippines. Trans Health, 193.

ASEAN S*xual Orientation, Gender Identity and Expression Caucus, Metro Manila Pride, Pioneer Filipino Transgender men Movement, GALANG Philippines, Lagablab LGBT Network, Babaylanes, Inc., Transman Equality and Awareness Movement, BISDAK Pride, Mujer-LGBT Organization, Inc., Side B Philippines, Rainbow Rights Philippines, & Inters*x Philippines. (2022). Universal Periodic Review: Joint Submission of the Civil Society Organizations (CSOs) on the Situation of Le***an, Gay, Bis*xual, Transgender, Inters*x and Q***r (LGBTIQ) Persons in the Philippines. In ASEAN SOGIE Caucus.

De Guzman, C. (2018, November 20). Philippine laws are still confused about gender. CNN. https://www.cnnphilippines.com/news/2018/11/20/philippine-laws-confused-gender.html

Philippine Daily Inquirer. (2016, October 9). In the know: S*x reassignment surgery. INQUIRER.net. https://newsinfo.inquirer.net/823333/in-the-know-s*x-reassignment-surgery

Singson, Y. (2019). “I’m Very Happy With Who I Am And I Owe It All To My Transition.” COSMO.PH. https://www.cosmo.ph/lifestyle/transgender-woman-philippines-a1194-20160802-lfrm

United Nations Development Programme & Commission on Human Rights of the Philippines. (2018). Legal Gender Recognition in the Philippines: A Legal and Policy Review.

World Health Organization. (2013). Regional assessment of HIV, STI and other health needs of transgender people in Asia and the Pacific.

Looking for places that offer medical transitioning? Contact either of the organizations presented to avail such services!

LoveYourself
Website: https://loveyourself.ph
Email: [email protected]
Mobile: 0917 628 8743; 0998 563 7307

Pulse Clinic
Website: https:/www.pulse-clinic.com.ph
Email: [email protected]
Mobile: 0917 124 5497

Change, transform, transition.

For trans people, transitioning is an integral part of discovering their true selves. Through different processes, trans people are able to carve out a unique path into a life in line with their gender identity.

Let’s get to know the types of transitioning that trans men and women undergo to express their true selves!

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Medical Transitioning

Permanently alters a trans person physically with the guidance and help of a medical professional.

This involves the use of hormones to cause chemical changes within the trans person's body and/or surgery to physically alter one's body.

Hormone Therapy

Involves treating trans people with s*x hormones in order to stimulate the development of secondary s*x characteristics.

For transfeminine people

Estrogen

Can be used to develop female physical characteristics and changes such as

1. Increased fat on the hips
2. Reduced facial and body hair
3. Reduced p***s and testicle size
4. Breast growth
5. Disrupted s***m production
6. Reduced muscle mass
7. Reduced s*x drive

For transmasculine people

Testosterone

Can be used to develop male physical characteristics and changes such as

1. Increased facial and body hair
2. Altered facial structure
3. Deepening of the voice
4. Muscle growth and fat distribution
5. Growth of the cl****is
6. Increased s*x drive
7. Stoppage of periods

Gender Affirming Surgery

Medical procedures that involve the surgical alteration of one's body which may include the face, chest, or genitalia.

For transfeminine people

Surgeries to aid in transitioning may include:

1. Breast augmentation (placement of silicone implants inside the chest)
2. Tracheal shave (making one’s Adam’s apple smaller)
3. Orchiectomy (Removing the te**es)
4. Vaginoplasty (creating a va**na)
5. Facial feminization surgery (altering parts of one’s face by changing the shape or size to achieve a more feminine appearance)

For transmasculine people

Here are some surgical procedures to name a few:

1. Mastectomy (removal of breasts and breast tissue)
2. Hysterectomy (removal of internal reproductive organs [e.g. ovaries and uterus])
3. Vaginectomy (removal of va**na and/or v***a)
4. Phalloplasty (constructing a p***s using skin from different parts of the body)
5. Laryngoplasty (alteration of vocal cords)

Why do trans people (medically) transition?

Transitioning is found to have a positive effect on trans people; it increases life satisfaction, confidence, and self-esteem

It also decreases negative effects such as depression, anxiety, suicidality, substance abuse, and lessens the experience of gender dysphoria.

References

Guy, F. (2023, June 19). Transitioning: Gender Identity (Social, Medical or Legal). Brook. https://www.brook.org.uk/your-life/transitioning/

Medical transition — TransActual. (n.d.). TransActual. https://www.transactual.org.uk/medical-transition

The What We Know Project. (2021, August 11). What does the scholarly research say about the effect of gender transition on transgender well-being? | What We Know. What We Know. https://whatweknow.inequality.cornell.edu/topics/lgbt-equality/what-does-the-scholarly-research-say-about-the-well-being-of-transgender-people/

Transition Roadmap | Gender Affirming Health Program. (n.d.). https://transcare.ucsf.edu/transition-roadmap

What Do I Need to Know About the Transitioning Process? (n.d.). Planned Parenthood. https://www.plannedparenthood.org/learn/gender-identity/transgender/what-do-i-need-know-about-transitioning

Change, transform, transition.

For trans people, transitioning is an integral part of discovering their true selves. Through different processes, trans people are able to carve out a unique path into a life in line with their gender identity.

Let’s get to know the types of transitioning that trans men and women undergo to express their true selves!

[TEXT VERSION]

Transitioning

Transitioning is all about making internal and external changes in order to live according to one's gender identity.

Gender transitioning is a unique path for any trans man or woman to get to know themselves.

ALL trans people who undergo the process get to become their truest selves.

Types of Transitioning

1. Internal (a self-realization of one's gender identity as a trans man or woman)

2. Social (a trans person's external expression of their gender identity such as: coming out to friends and family, making use of preferred pronouns, going by a chosen or lived name, gender-aligned behaviors, public expression)

3. Legal (legal change of name and gender in official records and government documents)

4. Physical (temporarily [e.g. chest binding, stuffing, tucking, packing, etc] or permanently changing a trans person's body)

References:

Guy, F. (2023, June 19). Transitioning: Gender Identity (Social, Medical or Legal). Brook. https://www.brook.org.uk/your-life/transitioning/

Medical transition — TransActual. (n.d.). TransActual. https://www.transactual.org.uk/medical-transition

The What We Know Project. (2021, August 11). What does the scholarly research say about the effect of gender transition on transgender well-being? | What We Know. What We Know. https://whatweknow.inequality.cornell.edu/topics/lgbt-equality/what-does-the-scholarly-research-say-about-the-well-being-of-transgender-people/

Transition Roadmap | Gender Affirming Health Program. (n.d.). https://transcare.ucsf.edu/transition-roadmap

What Do I Need to Know About the Transitioning Process? (n.d.). Planned Parenthood. https://www.plannedparenthood.org/learn/gender-identity/transgender/what-do-i-need-know-about-transitioning

Interested in learning more about the experiences of our Filipino trans brothers and sisters? Well look no further!

The Pastel Agenda is an information campaign whose aim is to demystify transitioning by informing the public about the current state of transgender health in the Philippines, particularly with regards to medical transitioning. By covering relevant topics such as basic information about medical transitioning, its importance, the availability and variety of services, as well as the current limitations trans individuals face in accessing these services, we seek to primarily educate cisgender, heteros*xual people, raise greater awareness for medical transitioning in the country, and stimulate further discussion of LGBTQ+ issues. From infographics to opinion pieces, keep an eye out for our releases over the next few days!

See you in a few!